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QUARTERLY REPORTING

 

FORM

 

Quarter Three| 7/1/19 - 9/30/19

Please complete the data form below.  If you are unable to answer a question you can leave the space blank and submit the form.  All fields with a red asterisk are required.

 

 

 

 

 Dental Blood Pressure Screening

 

Question #1

 

Total number of patients (all dental patients) seen during the reporting period.

Question # 2

 

Total number of blood pressure screenings performed during the reporting period.

Question #3

 

Total number of blood pressure screenings reported that were elevated (>140/90) during the reporting period.

UDS Measure- Dental Sealants
 Dental Treatment Plan 

 Dental No Shows
 

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2109 Stella Court

Columbus, OH 43215

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F | 614.884.3108

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